Impact of Artificial Intelligence or Telerehabilitation on Consumer Ratings in Physical Therapy: An Online Randomised Experiment
Physical Therapy · 30 Oct 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
As AI tools and telehealth enter musculoskeletal care, this suggests patients may trust clinicians less when AI use is visible, which matters for how clinicians communicate about technology.
The evidence
Australian adults (n=710) recruited through an online panel were randomly assigned to read one of four hypothetical physical therapy consultation scenarios that varied by delivery mode (in-person vs telehealth) and whether the therapist used AI. When the in-person visit was described as using AI, participants rated the therapist and service lower on every measure, for example perceived safety by about 0.8 points and intention to use by about 0.8 points on a 7-point scale. Telehealth without AI was also rated 0.2 to 0.7 points lower than in-person care, and the AI penalty was somewhat smaller in telehealth for a few outcomes.
A coherent primary effect estimate is unavailable. Clinical relevance does not estimate treatment benefit.
Why this rigour score?
RCTDesign starting point: 59.5
Raised the score
- Compared against current standard of care+3.4
- 3% loss to follow-up+0.7
Lowered the score
- No correction for multiple comparisons−3.4
Methods at a glance
Recorded assessment- Outcome assessors blindedNot reported
- Allocation concealedNot reported
- Random sequence generatedNot reported
- Intention-to-treat analysisNot reported
- Adequate statistical powerCalculation absent
- Prospective registrationNot met
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
See the full score breakdown
- Study design starting point
- 59.5
- Compared against current standard of care
- +3.4
- 3% loss to follow-up
- +0.7
- No correction for multiple comparisons
- −3.4
- Journal prior (not an observed method)
- +0.6
- Final rigour score rounded
- 61 / 100
Study design sets the starting point and a ceiling of 96. Recorded methods then adjust the score. Points are shown to one decimal place; the final score uses unrounded values.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.If patients rate a therapist or surgeon as less competent and less safe when AI is visibly used, how should clinicians explain AI-assisted documentation or decision support during a consultation?
2.Given that telehealth was rated lower than in-person care even without AI, which musculoskeletal patients would you still offer telerehabilitation to, and how would you counsel them about it?
Original publication title
Impact of Artificial Intelligence or Telerehabilitation on Consumer Ratings in Physical Therapy: An Online Randomized Experiment